Friday, 17 April 2015

SIRUS and Institute for Public Health in TV debate

On Tuesday I wrote about the new report published by the Norwegian Institute for Public Health (NIPH) and the media coverage of this. It was news agency NTB that wrote the misleading article focusing on possible harm to bystanders that would inhale nicotine ... and possibly get addicted and start smoking. Yeah right... so eating eggplant would put you in the danger zone as well then I guess?

The report itself, is not that bad in fact. As Dr. Farsalinos pointed out, it does have some serious errors, and those are of course creating problems in the media, but the report also concludes very clearly that e-cigarettes are a lot healthier than cigarettes, and that they could have very positive effect on public health. The issues we're left with is the gateway theory and nicotine exposure from "passive vaping".

I was hoping that SIRUS and Karl Erik Lund would help us explain to the public and the politicians that these issues are in fact nothing to worry about, and of course they did not let me down. The morning after, one of Norway's biggest TV channels, TV2, covered the case in the morning news. Not only did we get Karl Erik Lund in the studio discussing the report with head of NIPH, Camilla Stoltenberg, but we also got a live interview with Cathrine Skårn, board member of the Norwegian Union of Vapers (NDS). She did a fantastic job explaining what NDS is, what they're working for, what vaping is and that vaping is not smoking. As I've said so many times now, this fight will be fought in the media, and getting this kind of coverage on national TV is a huge step forward.

After the interview there is a debate in the studio with Karl Erik Lund and Camilla Stoltenberg. The whole thing is of course in Norwegian. I'm not going to translate the whole thing, just some important bits. It does indeed seem like the NIPH has a much more positive attitude towards vaping than what has been communicated in the newspapers this week. The first question from the host goes to Stoltenberg:

Host: ... our reporter talked to this woman who is very satisfied with her vaping. The question is: When she sits there vaping, is my colleague, Johannes, exposed to a form of passive smoking?

Stoltenberg: First of all I'd like to say that I totally agree with her that vaping is less dangerous than smoking and that it is much better that people that smoke switch to vaping. This is an important part of this picture. But when it comes to passive vaping, the point in the report is that passive vaping exists, and that one exposes the surroundings to levels of nicotine that in some cases might be comparable to those from passive tobacco smoking and quite a few other substances that it is difficult to say anything about the effects of in the long term. And it is in fact difficult to say anything about the effects of vaping in the long term because we don't have many studies on this.

Host: But how dangerous is it?

Stoltenberg: It is not very dangerous, because we are talking about low levels [of these substances], so if you compare it to tobacco smoking and passive tobacco smoking it is less dangerous. Our point is that it is not risk free, and we don't know enough about it.

After this, Karl Erik Lund agrees that vaping is not totally risk free, and says that no one has claimed that either. He then turns to explain the problem with how this was presented in the media the day before.

Lund: It is not the nicotine that is the dangerous substance in passive smoking for the bystanders, it is the nitrosamines, it's the monoxide, it's the metals and we don't have any of these in passive vaping...

Host: ... but there is nicotine?

Lund: There is nicotine, but the levels are so low that they are 10 times lower than what the The European Food Safety Authority (EFSA) has defined as a health risk, so focusing on that we can compare the nicotine exposure from these two products is a derailment of the debate about how to regulate these products...

After this Stoltenberg admits that even though they have focused on nicotine there are great uncertainties when it comes to how significant this is. The rest of the debate is mainly about how this should be regulated and whether we should use the precautionary principle. Stoltenberg also says that we will probably see different kinds of regulation in different countries and that we should monitor how these work when it comes to how many that quit smoking. She also claims that we don't know enough yet (yawn), but Lund explains that we actually do know a lot and that we need to regulate in a way that encourages smokers to switch to a product that also the NIPH now say exists. Finally, Stoltenberg say that they're mainly worried about the people that haven't started yet and that vaping might become common, even though she doesn't tell us why she thinks this is a problem.

To sum up, I think this TV coverage partly balanced out some of the misinformation from the day before. Karl Erik Lund does a great job as usual, no complaints there... and thank you again for your great efforts. Stoltenberg and the NIPH on the other hand... well they do seem more positive than ever. They do say that e-cigarettes work and that they are reducing harm and they can't really present any big issues. But it seems like they still want to say that they are worried. It almost seem like they need to be concerned, because they want to regulate. Since they haven't really found any big problems, they say they don't know enough yet. But let's not forget that they do very clearly state that e-cigarettes are a lot less harmful than cigarettes now, and that is another step in the right direction.

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Cathrine Skårn demonstrates vaping, live on national tv.

On Tuesday I wrote about the new report published by the Norwegian Institute for Public Health (NIPH) and the media coverage of this. It was news agency NTB that wrote the misleading article focusing on possible harm to bystanders that would inhale nicotine ... and possibly get addicted and start smoking. Yeah right... so eating eggplant would put you in the danger zone as well then I guess?

The report itself, is not that bad in fact. As Dr. Farsalinos pointed out, it does have some serious errors, and those are of course creating problems in the media, but the report also concludes very clearly that e-cigarettes are a lot healthier than cigarettes, and that they could have very positive effect on public health. The issues we're left with is the gateway theory and nicotine exposure from "passive vaping".

I was hoping that SIRUS and Karl Erik Lund would help us explain to the public and the politicians that these issues are in fact nothing to worry about, and of course they did not let me down. The morning after, one of Norway's biggest TV channels, TV2, covered the case in the morning news. Not only did we get Karl Erik Lund in the studio discussing the report with head of NIPH, Camilla Stoltenberg, but we also got a live interview with Cathrine Skårn, board member of the Norwegian Union of Vapers (NDS). She did a fantastic job explaining what NDS is, what they're working for, what vaping is and that vaping is not smoking. As I've said so many times now, this fight will be fought in the media, and getting this kind of coverage on national TV is a huge step forward.

After the interview there is a debate in the studio with Karl Erik Lund and Camilla Stoltenberg. The whole thing is of course in Norwegian. I'm not going to translate the whole thing, just some important bits. It does indeed seem like the NIPH has a much more positive attitude towards vaping than what has been communicated in the newspapers this week. The first question from the host goes to Stoltenberg:

Host: ... our reporter talked to this woman who is very satisfied with her vaping. The question is: When she sits there vaping, is my colleague, Johannes, exposed to a form of passive smoking?

Stoltenberg: First of all I'd like to say that I totally agree with her that vaping is less dangerous than smoking and that it is much better that people that smoke switch to vaping. This is an important part of this picture. But when it comes to passive vaping, the point in the report is that passive vaping exists, and that one exposes the surroundings to levels of nicotine that in some cases might be comparable to those from passive tobacco smoking and quite a few other substances that it is difficult to say anything about the effects of in the long term. And it is in fact difficult to say anything about the effects of vaping in the long term because we don't have many studies on this.

Host: But how dangerous is it?

Stoltenberg: It is not very dangerous, because we are talking about low levels [of these substances], so if you compare it to tobacco smoking and passive tobacco smoking it is less dangerous. Our point is that it is not risk free, and we don't know enough about it.

After this, Karl Erik Lund agrees that vaping is not totally risk free, and says that no one has claimed that either. He then turns to explain the problem with how this was presented in the media the day before.

Lund: It is not the nicotine that is the dangerous substance in passive smoking for the bystanders, it is the nitrosamines, it's the monoxide, it's the metals and we don't have any of these in passive vaping...

Host: ... but there is nicotine?

Lund: There is nicotine, but the levels are so low that they are 10 times lower than what the The European Food Safety Authority (EFSA) has defined as a health risk, so focusing on that we can compare the nicotine exposure from these two products is a derailment of the debate about how to regulate these products...

After this Stoltenberg admits that even though they have focused on nicotine there are great uncertainties when it comes to how significant this is. The rest of the debate is mainly about how this should be regulated and whether we should use the precautionary principle. Stoltenberg also says that we will probably see different kinds of regulation in different countries and that we should monitor how these work when it comes to how many that quit smoking. She also claims that we don't know enough yet (yawn), but Lund explains that we actually do know a lot and that we need to regulate in a way that encourages smokers to switch to a product that also the NIPH now say exists. Finally, Stoltenberg say that they're mainly worried about the people that haven't started yet and that vaping might become common, even though she doesn't tell us why she thinks this is a problem.

To sum up, I think this TV coverage partly balanced out some of the misinformation from the day before. Karl Erik Lund does a great job as usual, no complaints there... and thank you again for your great efforts. Stoltenberg and the NIPH on the other hand... well they do seem more positive than ever. They do say that e-cigarettes work and that they are reducing harm and they can't really present any big issues. But it seems like they still want to say that they are worried. It almost seem like they need to be concerned, because they want to regulate. Since they haven't really found any big problems, they say they don't know enough yet. But let's not forget that they do very clearly state that e-cigarettes are a lot less harmful than cigarettes now, and that is another step in the right direction.